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Group Therapy (TIP 41)
Chapter 1
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUsTraining Objectives
~ Goal:
◦ Provide an overview of group therapy used in substance abuse treatment.
~ Objectives:
◦ Discuss the use of group therapy in substance abuse treatment.
◦ Define five group therapy models used in substance abuse treatment.
◦ Explain the advantages of group therapy.
◦ Modify group therapy to treat substance abuse
Group Therapy in Treatment
~ Supports members in times of pain and trouble.
~ Enriches members with insight and guidance.
~ Is a natural ally with addiction treatment.
~ Has trained leaders.
~ Produces healing or recovery from substance abuse
Group Therapy in Treatment cont…
~ Can address factors associated with addiction
◦ Depression
◦ Anxiety
◦ Anger
◦ Shame
◦ Temporary cognitive impairment
◦ Character pathology
◦ Medication Management
◦ Pain Management
Advantages of Groups
~ Provide positive peer support for abstinence and positive action
~ Reduce isolation
~ Enable members to witness the recovery of others.
~ Allow members to see how others deal with similar problems.
Advantages of Groups (cont.)
~ Provide information to clients who are new to recovery.
~ Provide feedback on group members’ values and abilities.
~ Offer family-like experiences.
~ Encourage, coach, support, and reinforce.
Advantages of Groups (cont.)
~ Allow a single treatment professional to help a number of clients at the same time
~ Can add needed structure and discipline
~ Instill hope, a sense that “If he can make it, so can I.”
~ Support and provide encouragement to one another outside the group setting.
Summary
~ Group therapy is not individual therapy done with an audience
~ Group therapy is not a mutual support group
~ Group therapy is designed to help people develop and practice knowledge and skills in a microcosm
~ Group therapy also aids patients in learning how to develop healthy, supportive relationships
Module 2 Goal and Objectives
Goal: Provide details about the group therapy models used in substance abuse treatment.
Objectives:
~ Explain the stages of change.
~ Discuss the three specialized group therapy models used in substance abuse treatment.
Training Stages of Change
~ Precontemplation
~ Contemplation
~ Preparation
~ Action
~ Maintenance
~ Recurrence
Variable Factors for Groups
~ Group or leader focus
~ Specificity of the group agenda
~ Heterogeneity or homogeneity of group members
~ Open-ended or determinate duration of treatment
~ Level of leader activity
~ Duration of treatment and length of each session
~ Arrangement of room
~ Characteristics of the individuals
Psychoeducational Groups
~ Assist individuals in every stage of change
~ Help clients learn about
◦ Their disorders
◦ Treatment options
◦ Other resources
~ Provide family members with an understanding of the person in recovery.
Psychoeducational Groups
~ Educate about a disorder or teach a skill or tool
~ Work to engage clients in the discussion
~ Prompt clients to relate what they learn to their own issues (disorders, goals, challenges, successes)
~ Are highly structured and often follow a manual or curriculum.  Teach  Apply  Practice
Basic Teaching Skills
~ Components of Learning
◦ Capture (acquire knowledge)
 Auditory/Kinesthetic/Visual
 Global/Sequential
◦ Conceptualization (Relating to building blocks)
◦ Caring (Motivation)
Psychoeducational  Techniques
~ Foster an environment that supports participation
~ Encourage participants to take responsibility for their learning
~ Use a variety of learning methods that require sensory experiences
~ Are mindful of cognitive impairments
Skills Development Group Purpose
~ Cultivate skills necessary to
◦ Prevent relapse
◦ Achieve an acceptable quality of life
~ Assume clients lack needed skills.
~ Allow clients to practice skills.
~ Topics
◦ Skills directly related to recovery
◦ Skills necessary to thrive in general
Skills Development Groups
~ Have a limited number of sessions and a limited number of participants
~ Strengthen behavioral and cognitive resources
~ Focus on developing an information base on which decisions can be made and actions taken
Cognitive–Behavioral Groups
~ Conceptualize dependence as a learned behavior that is subject to modifications through various interventions.
~ Work to change learned behavior by changing thinking patterns, beliefs, and perceptions.
~ Include psychological elements (e.g., thoughts, beliefs, decisions, opinions, and assumptions).
Cognitive–Behavioral Groups:
~ Develop social networks that support abstinence so that the person with dependence becomes aware of behaviors that may lead to relapse and develops strategies to continue in recovery.
CBT Group Characteristics
~ Use educational devices.
◦ Worksheets/Journals
◦ Role plays
◦ Videos
~ Encompass a variety of approaches that focus on changing cognition and the behavior that flows from it.
Cognitive-Behavioral Techniques
~ Teach group members about self-destructive behavior and thinking that lead to maladaptive behavior.
~ Focus on problem solving and short- and long-term goal setting.
~ Help clients monitor feelings and behavior, particularly those associated with substance use.
Support Groups: Purpose
~ Are useful for apprehensive clients who are looking for a safe environment.
~ Bolster members’ efforts to develop and strengthen
◦ their ability to manage thinking and emotions
◦ interpersonal skills
~ Address pragmatic concerns.
~ Improve members’ self-esteem and self-confidence.
Support Group Characteristics
~ Often are open ended, with a changing population of members.
~ Encourage discussion about members’ current situations and recent problems.
~ Provide peer feedback and require members to be accountable to one another.
Support Groups: Techniques
~ Vary with group goals and members’ needs.
~ Include:
◦ Facilitate discussion among members
◦ Maintain appropriate group boundaries
◦ Help the group work through obstacles and conflicts
◦ Provide acceptance of and regard for members.
~ Ensure that interpersonal struggles among group members do not hinder group development
Interpersonal Process Groups
~ Recognize that conflicting forces in the mind, some of which may be outside one’s awareness, determine a person’s behavior, whether healthful or unhealthful.
~ Address developmental influences, starting in early childhood, and environmental influences, to which people are particularly vulnerable because of their genetic and other biological characteristics.
Interpersonal Process Groups
~ Delve into major developmental issues, searching for patterns that contribute to the problem or interfere with recovery.
~ Use psychodynamics, or the way people function psychologically, to promote change and healing.
~ Rely on the here-and-now interactions of members.
Summary
~ Multiple types of groups are available to assist clients in achieving their goals
~ View current coping skills as “creative adaptations”
~ Strengthening the healthy skills
~ Skills required to facilitate these groups overlap significantly
Summary:  Types of Groups
~ Psychoeducational (Knowledge/classroom)
~ Skills Development (Skills/lab)
~ Cognitive Behavioral
~ Support Groups
Summary: Making It Effective
~ Start group by telling what they are going to learn/do and why it is useful to them
~ Present an overview of what you are talking about
~ Have written material
~ Discuss the material and apply it
~ Have each group member close by identifying 1 thing they got out of group and how they will use it.